Family Planning in the Era of AIDS

An estimated 80% of HIV cases are transmitted sexually and 10% are transmitted during pregnancy, labor/delivery, or breastfeeding. Women and men need access to both family planning/reproductive health services because the same sexual act can result in HIV infection and unintended pregnancy. FP and HIV services offer many opportunities and challenge for integration. This paper addresses the evidence base on country experience from Africa, Asia and Latin American and the Caribbean with integration of FP into HIV policies and programs, including VCT, PMTCT and ART. The findings show that effective and successful integration of services requires policy and program guidance in the design and implementation in both the FP and HIV/AIDS settings. HIV policies are often developed without input from FP experts; thus FP is often left out of service delivery guidance. In many settings FP and HIV services are often run through parallel programs that are not always conducive to integration, which requires coordination of commodities and logistics, pre-service and in-service training for counseling and service provision (including contraceptive technology updates, non-judgmental treatment of clients and addressing misconceptions regarding FP among PLWHA and gender-based violence), supervision systems, referral systems with feedback, and monitoring and evaluation systems. NGOs are often most flexible in providing integrated services, although their reach can be limited. The paper also discusses current trends in integrating FP/RH into global AIDS initiatives, including the next iteration of PEPFAR and Global Fund to Fight AIDS, TB and Malaria grants which have invited components on FP/RH since Round 7.